Öner Çelik

Voice and Speech Changes in Various Phases of Menstrual Cycle

BACKGROUND The reproductive system in females undergoes a regular cyclic change known as the menstrual cycle. Laryngeal changes are evident and fluctuate systematically during the reproductive years with the menstrual cycle. The impact of estrogens in concert with progesterone produces the characteristics of the female voice, with a fundamental frequency (F(0)) higher than that of male. OBJECTIVE To characterize changes in voice and speech in adolescent females in different phases of the menstrual cycle--during menstruation, after menstruation, mid-menstrual cycle, and premenstruation. MATERIALS AND METHODS Sixteen adult females who were nonusers of oral contraceptives participated in a cross-sectional study of menstrual cycle influences on voicing and speaking tasks. Acoustic analysis (F(0), intensity, perturbation measurements [jitter and shimmer], and harmonic-to-noise ratio), maximum phonation time (MPT), s/z ratio, and perceptual assessments (grade [G], roughness [R], breathiness [B], asthenia [A], and strain [S] [GRBAS] and Voice Handicap Index-10 [VHI-10]) scales were performed during all phases. RESULTS None of the acoustic analysis parameters and MPT and s/z ratio measurements revealed statistically significant difference (P > 0.05). Perceptual voice assessment scales either clinician based or patients self-evaluated showed significant differences among phases (P < 0.05). CONCLUSIONS The objective voice analysis methods, such as acoustic analysis, MPT, and s/z ratio, determined no difference; however, the subjective voice analysis methods, such as clinician-based perceptual assessment (GRBAS) and patients self-evaluation (VHI-10) scales, demonstrated significant changes during different phases of menstrual cycle.

Efficacy of dexpanthenol for pediatric post-tonsillectomy pain and wound healing.

Objectives: We evaluated the efficacy of dexpanthenol in managing pediatric post-tonsillectomy pain and wound healing and sought to discover which of two surgical tonsillectomy techniques provides better healing and less postoperative pain. Methods: One hundred twenty patients who underwent tonsillectomy were equally randomized to thermal welding and cold dissection groups. Dexpanthenol pastilles were given to half of each group. Postoperative throat pain was determined with a visual analog scale on the 1st, 3th, 7th, and 14th days, and mucosal healing patterns were assessed on the 7th and 14th days. Results: Regardless of surgical technique, post-tonsillectomy throat pain was significantly less in the dexpanthenol groups than in the placebo groups (p < 0.05), and tonsillar wound healing was significantly better in the dexpanthenol groups than in the placebo groups (p < 0.05). When a comparison was made with regard to surgical technique, wound healing was significantly better in the cold dissection group (p < 0.05), whereas postoperative throat pain was less in the thermal welding group (p < 0.05). Conclusions: Postoperative administration of dexpanthenol significantly accelerates the wound healing process and decreases tonsillectomy-related pain complaints.

Conservative costal cartilage harvest for revision septorhinoplasty.

ObjectiveWe present our experience with a conservative costal harvesting to be used for patients undergoing secondary septorhinoplasty. MethodsSixty-five patients who underwent revision septorhinoplasty requiring autogenous costal cartilage harvest performed by the senior author from 2005 to 2011 have been included in this retrospective study. Assessment of the outcomes includes harvesting time, incision size, availability of graft material, and postoperative complications. ResultsThe mean operation time was 25 minutes. The incisions varied from 3 to 4 cm. Sufficient cartilage volume was harvested for the targeted purpose in all cases. No wound infection developed. One patient had pleural damage, and no more major complications were noted. The patients suffered from mild pain. Postoperative scar was minimal. No deformity was observed in the donor site on postoperative analysis. ConclusionsThe described technique is very safe and minimizes donor-site morbidity. In addition, it allows the acquisition of nonepithelialized dermal graft and muscle fascia for soft tissue reconstruction.

Thermal welding vs. cold knife tonsillectomy: a comparison of voice and speech.

OBJECTIVE To compare acoustic, aerodynamic and perceptual voice and speech parameters in thermal welding system tonsillectomy and cold knife tonsillectomy patients in order to determine the impact of operation technique on voice and speech. METHODS Thirty tonsillectomy patients (22 children, 8 adults) participated in this study. The preferred technique was cold knife tonsillectomy in 15 patients and thermal welding system tonsillectomy in the remaining 15 patients. One week before and 1 month after surgery the following parameters were estimated: average of fundamental frequency, Jitter, Shimmer, harmonic to noise ratio, formant frequency analyses of sustained vowels. Perceptual speech analysis and aerodynamic measurements (maximum phonation time and s/z ratio) were also conducted. RESULTS There was no significant difference in any of the parameters between cold knife tonsillectomy and thermal welding system tonsillectomy groups (p>0.05). When the groups were contrasted among themselves with regards to preoperative and postoperative rates, fundamental frequency was found to be significantly decreased after tonsillectomy in both of the groups (p<0.001). First formant for the vowel /a/ in the cold knife tonsillectomy group and for the vowel /i/ in the thermal welding system tonsillectomy group, second formant for the vowel /u/ in the thermal welding system tonsillectomy group and third formant for the vowel /u/ in the cold knife tonsillectomy group were found to be significantly decreased (p<0.05). CONCLUSIONS The surgical technique, whether it is cold knife or thermal welding system, does not appear to affect voice and speech in tonsillectomy patients.

Utility of Cartilage Grafts Wrapped With Amniotic Membrane in Dorsal Nasal Augmentation.

Objectives:The success of rhinoplasty may be compromised with postoperative problems like rough and rigid nasal dorsum. Biological grafts or alloplastic materials are required to hurdle and correct nasal dorsal deformities and also irregularities. The purpose of this experimental study was to compare pure cartilage graft, cartilage graft wrapped in amniotic membrane, and diced cartilage grafts wrapped in amniotic membrane for soft tissue augmentation. Methods:All grafts were transplanted through a subcutaneous tunnel created in the nasal dorsum of 18 rats, 6 in each group. After 3 months follow-up, the histopathological changes in all groups were evaluated by light microscopy and volumetric measurements. Results:With regard to cartilage viability, cartilage wrapped in amniotic membrane had a higher success rate than pure cartilage graft. Also, a further increased success rate was found in the diced group. Conclusions:In the soft tissue augmentation after rhinoplasty surgery, especially diced cartilage wrapped in amniotic membrane keeps the graft viable and adjoined.

The effect of duration of merocel in glove finger with tetracaine solution on septoplasty morbidity.

Objective We aimed to decrease the postseptoplasty morbidities depending on nasal packing by using Merocel within glove finger moistened with tetracaine 0.25% solution. Study Design The study was designed as a randomized prospective study. Setting A university hospital in Turkey. Subjects and Methods Our study consisted of 80 patients who underwent septoplasty. The Merocel nasal tampon within glove finger was inserted after surgery in the study group and removed after 24 or 48 hours. Merocel was moistened with tetracaine 0.25% solution after insertion into the nasal cavity and just before removal. The morbidities and normal breathing time were recorded and compared with those of the control group. Results The postseptoplasty morbidities were significantly decreased in the study group compared with those in the control group. The morbidities were also improved after removal of tampons after 24 hours compared with 48 hours. However, the normal breathing time was prolonged when the nasal tampons were removed after 24 hours. Conclusions The glove finger provides comfortable removal of nasal packing. The Merocel tampons might be safely removed just after 24 hours postoperatively without any complication.

Nadir Görülen Dil Kökü Schwannomu: Olgu Sunumu

Schwannoma also known as neurilemmoma, is benign, encapsulated, slow-growing tumor ofthe developing neural sheath’s Schwann cells. Aetiology is unknown. Usually appears betweenthe ages of 20-40. Aproximately 45% of the tumors are seen in the head and neck region. Only1% of them are encountered in the oral cavity. Tongue is the most common location in the oralcavity region. However location in the tongue base is very rare. A 26-year-old male patientadmitted to our clinic with a history of slowly growing swelling on the base of the tongue. Thepatient complained of the disturbance to mastication, swallowing and phonation. Diagnosis wasconfirmed by excisional biopsy. Histologic identification of Antoni A and B areas pathologicallycompleted the diagnosis of schwannoma. There was no recurrence in follow-up of 6 monthsafter the operation

Relation Between the Benign Paroxysmal Positional Vertigo and Environmental and Climatic Factors

Giriş Vertigo genel popülasyonda sık görülen bir semptomdur. Baş pozisyonunun yerçekimi yönüne göre değişimiyle ortaya çıkan kısa süreli rotatuar ataklarla karakterizedir (1, 2). Genellikle ani başlangıçlıdır ve sıklıkla uykudan uyanma sırasında yatakta hissedilir. Hastalar sıklıkla vertigonun baş hareketleriyle, yukarı veya aşağı bakışlarda ve yatakta dönmeler sırasında tekrarladığından bahsederler. Bulantı veya kusma azımsanmayacak sıklıkta bu duruma eşlik eder.